Use of cocaine has skyrocketed, and an increasing number of pregnant women are abusing this drug. Studies of neonates exposed to cocaine indicate neurobehavioral problems, however long-term follow-up studies are sparse. The broad objective of this study is to ascertain long- term consequences of cocaine exposure on specific cognitive and social/emotional competencies. The specific aims are 1) to determine the cognitive functions related specifically to prenatal cocaine exposure; and 2) to control the impact of the environment on development when assessing the effects of cocaine exposure. Pregnant women attending prenatal clinics for low income, high-risk patients in Trenton, NJ, and Northwest Philadelphia will be approached for participation in the study. Drug addiction counselors, maternal and newborn urine screens will help determine which women have been using cocaine during their pregnancies A greater number of non-substance abusing women will be approached as matched controls. Only fullterm, relatively healthy babies will be included in the sample. A sample of 245 cocaine-exposed and 265 control babies is anticipated. Multiple measures of learning, attentional processes, language, neuromotor ability and social/emotional behavior will be obtained at 7 time points from birth through 30 months of age. Studying these different aspects of competence permits an understanding of specific developmental effects of prenatal cocaine exposure. Detailed measures of the family environment, including extent of life stress, social support and quality of the caregiver-child interaction also will be collected. This study will work through programs and agencies designed to locate, follow, and provide intervention to high-risk pregnant women and mothers in Trenton and a cocaine treatment program for pregnant women in Philadelphia. A National Advisory Committee will be convened each year to review and guide the study.